Sleep quality and its associations with leisure-time exercise and excess weight among civil servants

O objetivo do estudo foi analisar a associação entre qualidade do sono, prática de exercícios físicos no lazer e obesidade entre servidores públicos de uma universidade. A amostra foi composta por 92 adultos de ambos os sexos. Qualidade do sono e atividade física foram coletadas por meio de questionário. O excesso de peso/obesidade foi diagnosticado pelo índice de massa corporal, o qual foi calculado com valores de peso e estatura relatados pelos avaliados. A prevalência de pessoas com sono alterado foi de 53,84%. Houve associação entre obesidade (OR= 7,22 [ORIC95%: 1,65-31,5]) e pior qualidade do sono, bem como, prática de atividade física e melhor qualidade do sono (OR= 0,19 [ORIC95%: 0,04-0,95]), independente de outros fatores de confusão. Concluiu-se que há alta ocorrência de distúrbios do sono, a qual foi associada de maneira independente com a prática de exercícios físicos e a obesidade.

Manutenção da prática de atividade física e indicadores hemodinâmicos, metabólicos e inflamatório em adultos: análise transversal e coorte de 12 meses

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Função pulmonar em indivíduos com SAOS antes e após o uso do CPAP: estudo randomizado duplo cego

Pós-graduação em Bases Gerais da Cirurgia - FMB

Deglutição orofaríngea e ritmos biológicos na insuficiência renal crônica

Pós-graduação em Fonoaudiologia - FFC

Prevalence of low back pain and associated factors in adults from a middle-size Brazilian city

Objective: To determine the prevalence of low back pain and some related variables among adults of both genders. Methods: Was conduct a cross-sectional study of population-based in the urban area of Presidente Prudente, São Paulo. The sample consisted of 743 adult residents for over two years in this city. Low back pain, quality of sleep and physical activity were collected through face to face interview at the residence of respondents. Was used the chi-square test to analyze the association between variables, later was created tree multivariate models with hierarchical inclusion of confounding factors. Results: The prevalence of low back pain reported last year was 50.2% (95% CI: 46.6, 53.8), and the last week 32.3% (95% CI: 28.9, 35.6). Was association among low back pain and females (p-value = 0.031), older age, lower education, altered sleep and overweight, the adjusted model found that people over the age of 45 years (45 to 59.9 years, OR = 13.1 [1.72-98.5] and ≥ 60 years, OR = 9.10 [1.15-71.7]), with some alteration of sleep (OR = 3.21 [1.84-5.61]) and obese (OR = 2.33 [1:26 to 4:33]) seems to be a risk group for low back pain. Conclusion: The prevalence of low back pain is high and obese people aged over 45 years, with any sleep disturbance are a group at higher risk for low back pain.

Association between sleep quality and quality of life in nursing professionals working rotating shifts

Objective: To analyze the association between sleep quality and quality of life of nursing professionals according to their work schedules. Methods: A prospective, cross-sectional, observational study was conducted between January and December 2010, with 264 nursing professionals, drawn from 989 subjects at Botucatu General Hospital and stratified by professional category. The Pittsburg Sleep Quality Index and the WHOQOL-bref were administered to evaluate sleep quality and quality of life, respectively. Self-reported demographic data were collected with a standard form. Continuous variables were reported as means and standard deviations, and categorical variables were expressed as proportions. Associations were evaluated using Spearman's correlation coefficient. The association of night-shift work and gender with sleep disturbance was evaluated by logistic regression analysis using a model adjusted for age and considering sleep disturbance the dependent variable. The level of significance was p < 0.05. Results: Night-shift work was associated with severe worsening of at least one component of sleep quality in the model adjusted for age (OR = 1.91; 95% CI 1.04; 3.50; p = 0.036). Female gender was associated with sleep disturbance (OR = 3.40; 95% CI 1.37; 8.40; p = 0.008). Quality of life and quality of sleep were closely correlated (R = -0.56; p < 0.001). Conclusions: Characteristics of the nursing profession affect sleep quality and quality of life, and these two variables are associated.

Métodos de avaliação da eficácia dos tratamentos para a dor

Pain is a subjective condition and, thus, difficult to measure. The best tools to assess pain are the pain evaluation questionnaires, which provide either diagnostic, pain evolution or pain intensity information. To provide information which could help differentiate between nociceptive pain and neuropathic pain is one of the most important functions of these questionnaires. The questionnaires can measure pain intensity, quality of life, or sleep quality. Quality of life and sleep are two really important characteristics to assess the pain impact on patients' life. Pain intensity assessing questionnaires combine physical evaluations with questions, providing information either from the patient sensations or clinical assessment of pain manifestations as well as the underlying biological mechanisms (such as hyperalgesia or allodynia). For example, the Pain Detect questionnaire has two parts: the patient form (intuitive, with pictures and easy understandable) and the physician form. Thus, in this questionnaire, subjective information is provided by the patient and the objective one is provided by the physician. Other pain intensity questionnaires are NPSI, DN4, LANSS or StEP. Quality of life questionnaires are versatile (can be used in different pathologies). These questionnaires include functional self-evaluation questions, and other ones associated to physical and mental health. Two of such quality of life questionnaires are SF-36 and NHP. Sleep evaluation questionnaires include quantitative features such as the number of sleep interruptions, sleep latency or sleep duration as well as qualitative characteristics such as rest sensation, mood and dreams. One of the most used sleep evaluation questionnaires is PSQI, which includes patient questions and bed-partner questions, providing information from two points of view.

Estudo randonizado duplo-cego da capacidade funcional e da prática de atividade física em indivíduos com diagnóstico polissonográfico de SAOS antes e após uso de CPAP

Pós-graduação em Bases Gerais da Cirurgia - FMB

Como os sintomas de transtornos mentais e comportamentais influenciam a memória operacional de universitários?

Pós-graduação em Psicologia do Desenvolvimento e Aprendizagem - FC

Stress levels and quality of sleep in subjects with temporomandibular joint dysfunction

Purpose: The aim of this study was to test the association between quality of sleep and stress in individuals with temporomandibular disorder (TMD). Methods: The study sample consisted of 354 adult subjects (males and females) from the municipality of Piacatu, São Paulo state, in the Southeast region of Brazil. Data were collected using the Fonseca’s Questionnaire to record the level of TMD, the Pittsburgh Sleep Quality Index (PSQI) to assess quality of sleep and the Social Readjustment Rating Scale (SRRS) to record stress level. The data were analyzed by the software Epi Info 2000 version 3.2 using a chi-square test at the 0.05 level of significance. Results: One hundred and eighty (50.8%) subjects had some level of TMD. The statistical analysis showed a significant relationship between the three stress scores and the presence or absence of sleep disorders, considering an overall PSQI score > 5 as an indicator of a subject with sleep problems (P<0.01). Conclusion: Both quality of sleep and stress levels were associated with TMD in this sample.

Comportamento, fluência verbal e ritmos circadianos em indivíduos com o Transtorno do Espectro do Autismo (TEA) antes e após o uso de melatonina

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Artrite reumatóide : implicações na funcionalidade das pessoas

Enquadramento: A Artrite Reumatóide (AR) é uma patologia com profundas implicações na funcionalidade das pessoas, com efeitos significativos não só ao nível do funcionamento físico, mas também a nível emocional, familiar, social e económico. Objetivos: Avaliar a funcionalidade das pessoas com artrite reumatóide e analisar a sua relação com as variáveis sócio demográficas, clínicas, dor e qualidade do sono. Métodos: Trata-se de um estudo não experimental, transversal, descritivo-correlacional e de caráter quantitativo, que foi realizado numa amostra não probabilística por conveniência, constituída por 75 pessoas com o diagnóstico de artrite reumatóide, acompanhadas na Unidade de Dor, na Consulta de Reumatologia e na Medicina Física de Reabilitação do CHTV, EPE. Para a mensuração das variáveis utilizou-se um instrumento de colheita de dados que integra uma secção de caracterização sócio demográfica e clínica, o Índice da Qualidade de Sono de Pittsburgh – PSQI e o Health Assessment Questionnaire – HAQ. Resultados: Constatou-se que 60,0% dos inquiridos apresenta dificuldades/incapacidades leves no desempenho das atividades da vida diária, 32,0% apresenta já dificuldades moderadas e 8,0% incapacidade grave, sendo que o valor médio da funcionalidade global avaliado por meio do HAQ foi de 1,48, o que revela a existência de uma incapacidade moderada na nossa amostra. Das variáveis sócio demográficas, a idade (p=0,003), a situação laboral (p=0,000), a escolaridade (p=0,006) e os rendimentos mensais (p=0,001) têm influência no estado funcional das pessoas com AR. Das variáveis clínicas, a intensidade da dor (p=0,007) e o tempo de diagnóstico da doença (p=0,013) mostraram relacionarem-se com a funcionalidade. Em relação à qualidade do sono, apenas existem diferenças estatísticamente significativas nas subescalas “levantar-se” (p=0,030) e “caminhar” (p=0,034), sendo que a má qualidade de sono configurou-se em 94,7% dos inquiridos. Conclusão: As evidências encontradas neste estudo referem que a idade, a situação laboral, a escolaridade, os rendimentos mensais, o tempo de diagnóstico, a intensidade da dor e a qualidade do sono, associam-se a uma pior funcionalidade nas pessoas com AR. O diagnóstico precoce, a adoção de medidas para a promoção da boa qualidade do sono, a aplicação de medidas farmacológicas e não farmacológicas para o alívio da dor, e ações de formação direcionadas aos doentes com AR, devem ser estratégias a desenvolver junto desta população, numa tentativa de minimizar o impacto negativo que esta doença acarreta. Palavras-chave: artrite reumatóide, estado funcional, qualidade do sono.

A relação entre transtorno da insônia e funções executivas em adultos

The insomnia disorder is defined as a difficulty initiating or maintaining sleep or waking up earlier than expected unable to return to sleep, followed by a feeling of nonrestorative and poor quality sleep, present for at least three months, with consequences on daytime functioning. Studies have shown that insomnia affects cognitive function, especially executive functions. However, researches that sought to investigate the relationship between primary insomnia and executive functioning were quite inconsistent from a methodological point of view, especially in regard to the variability of the used methods, the heterogeneity of diagnostic criteria for insomnia and the control of sleep altering drugs. In this sense, the present study aimed to investigate the relationship between insomnia and executive functions in adults. The participants were 29 people, from both genders, aged 20-55 years old. Participants were divided into three groups, one composed of 10 people with primary insomnia who used sleep medication (GIM), nine people with primary insomnia who did not use medication (GInM) and 10 healthy people who composed the control group (CG). The research was conducted in two stages. The first one involved a diagnostic evaluation for insomnia disorder through a clinical interview and the application of the following protocols: the Athens Insomnia Scale, the Insomnia Severity Index, Sleep Journal (for 14 days), Pittsburgh Sleep Quality Index (PSQI), the Stanford Sleepiness Test, depression and anxiety Beck inventories, and Lipp’s Iventory of stress symptoms for adults. After this stage, the evaluation of executive functions was performed by applying a battery of neuropsychological tests composed by the following tests: Wisconsin, Stoop Test, Colored trails Test, the Tower of London Test, Iowa Gambling Task (IGT) and WAIS III subtest digit span, which measured selective attention, inhibitory control, cognitive flexibility, planning, problem solving, decision making and working memory, respectively. The results showed that insomniacs (GIM and GInM) showed higher sleep latency, shorter sleep duration and lower sleep efficiency compared to the CG. In regard to the performance in executive functions, no statistically significant difference between groups was observed in the evaluated modalities. However, the data show evidence that, compared to GInM and GC, the performance of GIM was lower on tasks that required quick responses and changes in attention focus. On the other hand, GInM, when compared to GIM and GC, showed a better performance on tasks involving cognitive flexibility. Furthermore, impaired sleep measures were correlated with the worst performance of insomniacs in all components evaluated. In conclusion, people with the insomnia disorder showed a performance similar to healthy people’s in components of the executive functioning. Thus, one can infer that there is a relationship between primary insomnia and executive functions in adults.

Influência do jet lag social em marcadores circadianos de atividade - repouso e cardíaco em estudantes de medicina

Studies reveal that in recent decades a decrease in sleep duration has occurred. Social commitments, such as work and school are often not aligned to the "biological time" of individuals. Added to this, there is a reduced force of zeitgeber caused by less exposure to daylight and larger exposure to evenings. This causes a chronic sleep debt that is offset in a free days. Indeed, a restriction and extent of sleep called "social Jet lag" occurs weekly. Sleep deprivation has been associated to obesity, cancer, and cardiovascular risk. It is suggested that the autonomic nervous system is a pathway that connects sleep problems to cardiovascular diseases. However, beyond the evidence demonstrated by studies using models of acute and controlled sleep deprivation, studies are needed to investigate the effects of chronic sleep deprivation as it occurs in the social jet lag. The aim of this study was to investigate the influence of social jet lag in circadian rest-activity markers and heart function in medical students. It is a cross-sectional, observational study conducted in the Laboratory of Neurobiology and Biological Rhythmicity (LNRB) at the Department of Physiology UFRN. Participated in the survey medical students enrolled in the 1st semester of their course at UFRN. Instruments for data collection: Munich Chronotype Questionnaire, Morningness Eveningness Questionnaire of Horne and Östberg, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Actimeter; Heart rate monitor. Analysed were descriptive variables of sleep, nonparametric (IV60, IS60, L5 and M10) and cardiac indexes of time domain, frequency (LF, HF LF / HF) and nonlinear (SD1, SD2, SD1 / SD2). Descriptive, comparative and correlative statistical analysis was performed with SPSS software version 20. 41 students participated in the study, 48.8% (20) females and 51.2% (21) males, 19.63 ± 2.07 years. The social jet lag had an average of 02: 39h ± 00:55h, 82.9% (34) with social jet lag ≥ 1h and there was a negative correlation with the Munich chronotype score indicating greater sleep deprivation in subjects prone to eveningness. Poor sleep quality was detected in 90.2% (37) (X2 = 26.56, p <0.001) and 56.1% (23) excessive daytime sleepiness (X2 = 0.61, p = 0.435). Significant differences were observed in the values of LFnu, HFnu and LF / HF between the groups of social jet lag <2h and ≥ 2h and correlation of the social jet lag with LFnu (rs = 0.354, p = 0.023), HFnu (rs = - 0.354 , p = 0.023) and LF / HF (r = 0.355, p = 0.023). There was also a negative association between IV60 and indexes in the time domain and non-linear. It is suggested that chronic sleep deprivation may be associated with increased sympathetic activation promoting greater cardiovascular risk.

Caraterísticas miofuncionais orofaciais de indivíduos com roncopatia a envelhecer: adaptação de um protocolo de avaliação

Introdução: Vários estudos afirmam que a hipotonia das estruturas orofaríngeas está diretamente relacionada com a Roncopatia, sendo esta altamente prevalente em idosos. Um instrumento que avalie as caraterísticas miofuncionais orofaríngeas vai proporcionar um melhor conhecimento das alterações inerentes ao Ronco. Objetivos: Realizar a adaptação, para o Português Europeu, do protocolo de Avaliação Miofuncional Orofacial MBGR - adaptado para AOS e Ronco; Realizar a validação cultural da adaptação, para o Português Europeu, do protocolo de Avaliação Miofuncional Orofacial MBGR – adaptado para AOS e Ronco; Identificar as caraterísticas Miofuncionais Orofaciais de um grupo de indivíduos com Roncopatia. Metodologias: Adaptação do referido instrumento para o Português Europeu e consequente validação cultural, realizada por peritas de Língua Portuguesa e peritas em Motricidade Orofacial tendo sido igualmente aplicado a 8 indivíduos com Roncopatia. Resultados: Após as várias fases de adaptação do protocolo e aplicação a 8 elementos chegou-se ao protocolo adequado para medir o constructo a que se propõe. 6 indivíduos com Roncopatia são do sexo feminino. 100% da amostra apresenta a língua no assoalho da boca, como posição habitual, sendo que 87% tem uma largura de língua aumentada. 6 elementos da amostra têm o palato duro alto e estreito. O palato mole é identificado com assimetria e uma grande extensão. Metade da amostra apresenta úvula muito longa. Conclusões: O protocolo padronizado, aqui apresentado, é fundamental para nortear o tratamento, diminuindo as alterações Miofuncionais Orofaciais, reduzindo o ronco e melhorando a qualidade de sono do indivíduo.